| NPI | 1801949540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: MI 4301105599) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301105599) |
| 207VX0201X Obstetrics & Gynecology, Gynecologic Oncology (Licence: WI 55857) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2019-06-03 |